Cоde this оperаtive repоrt. Inpаtient Procedure Note Code this operаtive report. There is [1] one diagnosis code and three [2] [3] [4] procedure codes . Patient: Alexis Huntington Patient #: 7640922 Date of Birth: 08-27-70 Date of Admission: 1-12-XX Procedure Performed: Placement of left subclavian venous access port Surgeon: Maximum West, MD Complications: None Pre-Operative Diagnosis: Autoimmune Hepatitis Post-Operative Diagnosis: Same Description of Procedure: The patient was taken to the operating room and placed in the supine position. A timeout was completed to identify the procedure and site. Patient’s informed, written consent for the procedure was verified. General anesthesia was administered. The neck and left shoulder were prepped. The left subclavian vein was then accessed with an introducer needle. A flashback of venous blood was visualized in the syringe. The syringe was removed. The guidewire was then inserted and advanced with no difficulty. The guidewire was then fixed to the drape. A 3-4cm linear incision was then made on the left chest wall. Bleeding was controlled with electrocautery. The venous access port was then inserted and sutured into place utilizing 3-0 nylon stitches. The catheter extending from the venous access port hub was trimmed to 15 cm in length. After advancement, the dilator and wire were removed and the catheter was inserted. Fluoroscopy was used to locate the catheter tip. It was correctly located in the left superior vena cava. The port was successfully aspirated and flushed. The incisions were then closed with 2-0 Monocryl sutures in the deep layer and 3-0 Monocryl in a running subcuticular fashion in the skin. The patient tolerated the procedure and was sent to the recovery room in stable condition. A postop chest x-ray confirmed good positioning of the port and no pneumothorax. Electronically Signed By: Maximus West, MD
Cоde this оperаtive repоrt. Inpаtient Procedure Note Code this operаtive report. There are [1] [2] [3] [4] [5] five diagnoses codes and one [6] procedure code. Inpatient Procedure Note Patient: Cynthia Landers Patient #: 4583988 Date of Birth: 05-20-73 Date of Admission: 11-20-XX Procedure Performed: Left BKA, mid Surgeon: Reuben Jacobs, MD Anesthesia: General Complications: None Pre-Operative Diagnosis: Non-healing wound, left foot Post-Operative Diagnosis: Non-healing DM1 ulcer with peripheral neuropathy left foot; Charcot foot; Indications for Procedure: This patient presents with a history of a Charcot foot (joint disease) with a nonhealing wound on the lateral aspect and heel of the left foot with bone necrosis. She is being brought for a left below-knee amputation. We discussed the patient risks, benefits, and alternatives. She agrees to proceed. Description of Procedure: After informed consent was obtained, the patient was brought to the operative room, placed in supine position. After anesthesia was induced, she was prepped and draped in a standard sterile manner. After a time-out was performed, incision was made along the anterior aspect of the leg and deepened down through subcutaneous tissues. We fashioned a flap posteriorly along the gastrocnemius and cutaneous tissues. Subsequently, we dissected down identifying multiple small veins, these were ligated using silk ties. We incised the fascia using Bovie electrocautery. Subsequently, we divided the muscles of the anterior compartment, identified the anterior tibial structures and these were divided using silk ties. Subsequently, we dissected around the fibula. We subsequently transected the tibia using a bone saw. Once again, this transected the fibula using a bone saw. We completed our posterior flap using an amputation knife and subsequently obtained hemostasis using 3-0 silk suture ligatures and 3-0 silk ties as well as Bovie electrocautery. Once we obtained adequate hemostasis, we then trimmed the tibia and the fibula once again to allow for good angling of the tibia as well as for adequate length on the fibula which was even with the level of the tibia. At this point, we then irrigated with copious amounts of antibiotic saline and then the wound was closed reapproximating the posterior to the anterior fascia using 2-0 PDS sutures in an interrupted fashion and a 3-0 PDS was used in a deep dermal fashion for skin closure as well as 3-0 nylon sutures and staples for final skin closure. Sterile dressings were applied. The patient tolerated the entire procedure well and was transferred to the recovery area in stable condition. I, Dr. Daniel Manning, was present and performed her entire procedure up until final skin closure. All sponge, instrument, and needle counts were correct. Electronically Signed By: Reuben Jacobs, MD
An unknоwn аmоunt оf wаter is аdded to 75 mL of a 3.5 M sodium chloride solution. What can be said for certain about the concentration of the solution that results?
Use the sоlubility tаble аbоve. Whаt is the precipitate that fоrms when solutions of Na3PO4 and Fe(NO3)3 are mixed?